Provider Demographics
NPI:1255056412
Name:A VILLAGE OF LOVE HOMECARE LLC
Entity type:Organization
Organization Name:A VILLAGE OF LOVE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NACHELLE
Authorized Official - Middle Name:MISHON
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-600-6839
Mailing Address - Street 1:2242 N GRAHAM AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-4136
Mailing Address - Country:US
Mailing Address - Phone:317-600-6839
Mailing Address - Fax:
Practice Address - Street 1:2242 N GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-4136
Practice Address - Country:US
Practice Address - Phone:317-600-6839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care